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Pennsylvania rates for HCPCS 75573

Computed tomography, heart, with contrast material, for evaluation of cardiac structure and morphology in the setting of congenital heart disease (including 3D image postprocessing, assessment of left ventricular [LV] cardiac function, right ventricular [RV] structure and function and evaluation of vascular structures, if performed)

Facilitymedian $339 · 10th–90th $132–$5250%10%20%10th90th$339$200.0$500.0$1.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$144.54 / $346.74 / $524.81
Martin's Point
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$131.83 / $234.42 / $407.38
UPMC Health Plan
Facility/Professional
Facility
Modifier
26
Typical Low / Median / Typical High
$112.20 / $112.20 / $117.49